- Title
- Hemorrhage and thrombosis in COVID-19-patients supported with extracorporeal membrane oxygenation: an international study based on the COVID-19 critical care consortium
- Creator
- Feth, Maximilian; Weaver, Natasha; Kim, Bo S.; White, Nicole; Suen, Jacky Y.; Li Bassi, Gianluigi; Peek, Giles J.; Lorusso, Roberto; Dalton, Heidi; Fraser, John F.; Fanning, Jonathon P.; Fanning, Robert B.; Cho, Sung-Min; Griffee, Matthew J.; Panigada, Mauro; Zaaqoq, Akram M.; Labib, Ahmed; Whitman, Glenn J. R.; Arora, Rakesh C.
- Relation
- Journal of Intensive Care Vol. 12, no. 18
- Publisher Link
- http://dx.doi.org/10.1186/s40560-024-00726-2
- Publisher
- BioMed Central (BMC)
- Resource Type
- journal article
- Date
- 2024
- Description
- Background: Extracorporeal membrane oxygenation (ECMO) is a rescue therapy in patients with severe acute respiratory distress syndrome (ARDS) secondary to COVID-19. While bleeding and thrombosis complicate ECMO, these events may also occur secondary to COVID-19. Data regarding bleeding and thrombotic events in COVID-19 patients on ECMO are sparse. Methods: Using the COVID-19 Critical Care Consortium database, we conducted a retrospective analysis on adult patients with severe COVID-19 requiring ECMO, including centers globally from 01/2020 to 06/2022, to determine the risk of ICU mortality associated with the occurrence of bleeding and clotting disorders. Results: Among 1,248 COVID-19 patients receiving ECMO support in the registry, coagulation complications were reported in 469 cases (38%), among whom 252 (54%) experienced hemorrhagic complications, 165 (35%) thrombotic complications, and 52 (11%) both. The hazard ratio (HR) for Intensive Care Unit mortality was higher in those with hemorrhagic-only complications than those with neither complication (adjusted HR = 1.60, 95% CI 1.28–1.99, p < 0.001). Death was reported in 617 of the 1248 (49.4%) with multiorgan failure (n = 257 of 617 [42%]), followed by respiratory failure (n = 130 of 617 [21%]) and septic shock [n = 55 of 617 (8.9%)] the leading causes. Conclusions: Coagulation disorders are frequent in COVID-19 ARDS patients receiving ECMO. Bleeding events contribute substantially to mortality in this cohort. However, this risk may be lower than previously reported in single-nation studies or early case reports. Trial registration: ACTRN12620000421932.
- Subject
- coagulation disorders; COVID-19; extracorporeal membrane oxygenation; bleeding events; thrombotic events
- Identifier
- http://hdl.handle.net/1959.13/1505986
- Identifier
- uon:55787
- Identifier
- ISSN:2052-0492
- Rights
- x
- Language
- eng
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